Infertility treatments involving ovulation induction are associated with an increased incidence of twins and higher order multiple pregnancy (4; Figure 11.1). The natural incidence of twins is one in eighty pregnancies and for triplets it is one in six thousand. Ovulation induction alone increases the incidence of twins four-fold. A study of twenty-four thousand IVF pregnancies found a 25-fold increase in the incidence of twins and a 350-fold increase in triplets.
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Figure 11.1
Multiple pregnancy is regarded as 'high-risk' in obstetrics as all the potential complications of pregnancy occur more frequently. These include maternal problems such as anaemia, urinary tract infection, high blood pressure and bleeding. Miscarriage, premature delivery, poor placental function reducing the growth rate of the babies, perinatal mortality (stillbirths and babies dying in their first week) are all more frequent in twins. These problems are disproportionately more likely to occur with higher order pregnancies (Figure 11.2).
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Figure 11.2
Related Medical Abstracts - Click on the paper title:-
- Preterm birth in twins after subfertility treatment: population based cohort study. (2005-01)
- Perinatal outcomes of in vitro fertilization twins: a systematic review and meta-analyses. (2005-02)
- The risk of mortality or cerebral palsy in twins: a collaborative population-based study. (2002-01)
- Comparison of risk factors for cerebral palsy in twins and singletons. (2002-02)
- Assisted reproductive technologies: Estimates of their contribution to multiple births and newborn hospital days in the United States (1996)
- Perinatal outcome of twin pregnancies obtained after in vitro fertilization: Comparison with twin pregnancies obtained spontaneously or after ovarian stimulation (1996)
- Perinatal outcome of triplet pregnancies following assisted reproduction (1994)
- Triplets and quadruplets born in Victoria between 1982 and 1990: The impact of IVF and GIFT on rising birthrates (1993)
- Outcome of twin, triplet, and quadruplet in vitro fertilization pregnancies: The Norfolk experience (1992)
- Births in Israel resulting from in-vitro fertilization/embryo transfer, 1982-1989: National registry of the Israeli association for fertility research (1992)
Please click on the required question.
- 1 How successful is infertility treatment?
- 2 How can we compare infertility treatments?
- 3 How can we compare outcomes between different fertility units?
- 4 Are treatments for infertility improving?
- 5 Is there an increased chance of miscarriage following infertility treatment?
- 6 Is there an increased chance of ectopic pregnancy following infertility treatment?
- 7 What is a heterotopic pregnancy?
- 8 What problems can occur with multiple pregnancy?
- 9 What is selective termination of pregnancy?
- 10 How can the pregnancy risks following infertility treatment be reduced?
- 11 We have had infertility treatment which has been successful. How will our pregnancy be cared for?
- 12 If we have infertility treatment, will our baby be healthy?
- 13 What are the psychological effects of infertility? information?
- 14 Where can I obtain more information?
- 15 Infertility Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
